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Home My WebLink AboutZ-27616FORM NO. 4 TOWN OF SOUTROLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. PRE EXISTING CERTIFICATE OF OCCUPANCY No: Z- 27616 Date: 04/11/01 THIS CERTIFIES that the building DWELLING Location of Property 9780 SOUND AVE (HOUSE NO.) County T~x Map NO. 473889 Section 122 Subdivision MATTITUCK (STREET) (HAMLET) Block 0002 Lot 024.001 Filed Map NO. __ Lot No. __ conforms substantially to the Requirements for a ONE FAMILY DWELLING built prior to APRIL 9, 1957 pursuant to which C~KTIFICATE OF ~CNJP~/~CY ~JMB~ Z- 27616 dated APRIL 11, 2001 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ONE FAMILY DWELLING WITH ACCESSORY 3 CAR WOOD FRAME GARAGE * The certificate is issued to C}{ARLOTTE DICKERSON ( OWNER of the aforesaid building. SUFFOLK COU~FrYDEPART~ENTOFH]~%LTHAPPROVAL ELEC-iaICAL CERTIFICATE NO. PLUMBERS CERTIFICATION DA'rKu *PLEASE SEE ATTACHED INSPECTION REPORT. N/A N/A N/A '~/~Signature Rev. 1/81 BUILDING DEPARTMENT TOWN OF SOUTHOLD HOUSING CODE INSPECTION REPORT 9780 SOUND AVE ~ OF O~ (S): CHARLOTTE DICKERSON OCCUPANCY: SINGLE FAMILY DWELLING /%/]MI-~-r~ BY: CHARLOTTE DICKERSON MATTITUCK MAP NO.: ~ (S) CHARLOTTE DICKERSON SO. CE OF ~ST: CH~%RLOTTE DICKERSON, 3/13/01 DATE: 04/11/01 (FfH~: PATRY OFF THE KITCHEN & A REAR ENTRYWAY ACCESSORY STRUCTURES: VIOLATIONS: CHAPTER 45 N.Y. STATE UNIFORM FIRE PREVENTION & BUILDING CODE LOCATION DESCRIPTION ART. SEC. P~: BP#gB92Z-COZ-9404 (ACCESSORY SHED) DA~'E (7~ INSPECTION: 03/30/01 TI~E START: 10:00 AM ]~D: 10:20 AM Form No. 6 TOWN OF SOUTIIOLD BUILDING DEPARTMENT TOWN HALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate of Code Compliance from architect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and pre-existing land uses: 1.Accurate survey of property showing all property lines, streets, building unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees f. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existinR Buildinm - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00 Date March 13, 2001 New Construction ........... Old Or Pre-existing Building ....... ~ ......... Location of Property..~7~. Sound Avenue ......................... % ............ Mattituck House No. Street Hamlet Charlotte Dickerson Onwer or Owners of Property .................................................................. County Tax Map No 1000, "e ~- 122 00 9~ p~ ~ c~ ........ : ........ Block... : ..... Lot. P/O 024.000 Subdivision .................................... Filed Map ............ Lot ...................... Permit No ................ Date Of Permit ................ Applicant ............................. Health Dept. Approval.' ....................... Underwriters Approval ......................... Planning Board Approval ..................... Request for: Temporary Certificate ........... Final Certicate.. X Fee Submitted: ~ 100.00 ..... CO ~7~/~ " APPLICANT Charlotte Dickerson CHARLOTTE DICKERSON CONSENT TO INSPECTION · the undersigned, Owner(z) Name(a) do(es) hereby state: That the undersigned (is) (~) the owner(~) of the premises in the Tow~ of Southold located at 9780 Sound Avenue, Mattituck, New York · which is shoxwn and designated on the Suffolk County tax map as District 1000, Section 122 , Block 2 , Lot P/0 24 That the undersigned (has) (have) filed, or caused to be filed, an applica- tion in the Southold Town Building Inspector's Office for the following: Certificate of Occupanc~y on Pre-existing Building That the undersigned do(es) hereby give consent to the Building Inspectors of the Town of Southold to enter upon the above described property, including any and all buildings located thereon· to conduct such inspections as they may deem necessary with respect to the aforesaid application, including inspections to determine that said premises comply with all of the laws· ordinances, rules and regulations of the Town of Southold. The undersigned, in consenting to such inspections, do(es) so with the knowledge and understanding that any information obtained in the conduct of such inspections may be used as evidence in subsequent prosecutions for vio- lations of the laws, ordinances, rules or regulations of the Town of Southold. Dated: March 13, 2001 ~_~k~g/2~x_ ~c_]~_o~ (signature) Charlotte Dickerson (print name) (signature) (print name)